1. Field of the Invention
The present invention relates to apparatus and methods for removing fatty tissue from a human body without damaging underlying nerves.
2. Brief Description of the Related Art
Recent advances in cardiology, radiology, cardiothorasic vascular and neuro surgery have allowed patients suffering from various diseases of the internal organs to benefit from less invasive techniques to surgically treat their conditions. With the advent of newer techniques, however, come newer difficulties in the application of these techniques to all the qualified patients.
Recent advanced techniques and devices allow for the correction of numerous defects of the internal organs, e.g., the heart, by access to the surface of the organs. For example, performing coronary artery bypass surgery on a beating heart has been used to treat coronary artery disease, attaching leads to the exterior surface of the heart to collect diagnostic data and to pace the heart, or performing atrial fibrillation procedures. In all of these procedures, however, often a thick layer of fatty tissue must be removed from around the heart to expose the myocardial tissue to be treated. To further complicate the procedure, the fatty layer may be enveloped in a tougher layer of connective tissue, the pericardium, which must first be incised to expose the fat underneath. Furthermore, the vasculature which provide blood to the heart itself, the coronary arteries and veins, may be located on the exterior of the cardiac tissue and under and in the fat. The coronary arteries and cardiac veins traverse the myocardial surface, supplying oxygenated blood and conducting deoxygenated blood away from the cardiac tissues, respectively. Typically, the pericardium is cut with a scalpel to expose the fat underneath, which in turn is incised with a scalpel to expose the surface of the heart to perform a procedure, e.g., bypass surgery, pacing lead attachment, atrial fibrillation procedures, etc. The use of a scalpel to remove the fat clearly presents a level of danger to the patient's coronary arteries which is only marginally tolerable; the consequences of mishap are severe.
The fat layer is generally a semi liquid form at body temperature. At elevated temperatures the fatty tissue will become more liquified. The cell membranes of the fat tissue can be ruptured when they are mechanically stressed, which will allow the fat contents of the cell to flow freely.
Prior devices exist which aspirate fat or other substances from the body of a patient, but which are not suitable for removing the fat layer from the external surface of an internal body organ. Laparoscopes exist, but are not useful because they cannot break up fatty tissue while ensuring that larger blood vessels which are located under the fat are not also severed. Numerous atherectomy devices have been proposed, however they are far too small to be effectively employed to remove the sometimes large volumes of fat which covers the organ, and also do not provide any protection for the underlying nerves and blood vessels.
Protecting the underlying nerves from damage is especially important. For example, in thoracic surgery as well as in other surgical procedures, identification of nerves is critical. Failure to identify nerves during surgery could result in those nerves being inadvertently damaged. Nerves are often enclosed or covered with fat, making their identification and isolation particularly difficult. Generally, those skilled in the art must identify nerves by slowly dissecting with scissors and forceps. Failure to identify nerves can lead to severe disability should those nerves be injured as a result. Injuries include numbness as well as the inability to move. Frequently, these injuries are permanent.
Within dermatology and plastic surgery, the inner surface of the skin is aspirated for fat. Nerves and vessels that are in the same space can be easily damaged. Identification of these vessels and nerves prior to injury is important.
Within thoracic, neurosurgery and vascular surgery, procedures to isolate parts of a nerve in order to create therapeutic benefit are becoming increasingly common. For example, stellate ganglion procedures for hyperhydrosis (i.e. excessive sweating) require careful dissection, identification and treatment of the ganglion. If it were possible to identify and isolate the nerve more quickly, these procedures would be safer and faster to do. Therefore there is a need for an innovative device that allows the surgeon to separate underlying nerves from their covering fat. Such a device is herein disclosed.
Another commonly performed procedure is liposuction, usually performed for cosmetic improvement. Frequently, nerve damage occurs due to nerves being injured by the suction device The invention herein described would be beneficial to identifying nerves prior to injury and also would aid in the removal of fat without associated nerve injury.